仁术三黄方治疗乳腺癌术后内分泌治疗期气虚血瘀证临床疗效观察  

Clinical Observation of Renzhu Sanhuang Formula in the Treatment of Qi Deficiency and Blood Stasis Pattern of Postoperative Endocrine Treatment Period for Breast Cancer

作　　者：王聪[1] 张曦平 姚昶[1] 许岩磊[1] 倪婷[1] 张晓清[1] WANG Cong;ZHANG Xiping;YAO Chang;XU Yanlei;NI Ting;ZHANG Xiaoqing(Affiliated Hospital of Nanjing University of TCM,Nanjing 210029,China)

机构地区：[1]南京中医药大学附属医院,江苏南京210029

出　　处：《西部中医药》2024年第10期93-97,共5页Western Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81804103);江苏省中医院高峰学术人才培养项目(y2018rc11);江苏省中医院培育项目(Y20031)。

摘　　要：目的:观察仁术三黄方治疗乳腺癌术后内分泌治疗期气虚血瘀证的临床疗效。方法:将乳腺癌术后接受内分泌治疗的60例气虚血痧证患者随机分为对照组和治疗组各30例。对照组予乳腺癌术后内分泌治疗,治疗组在对照组基础上予仁术三黄方中药口服。比较两组患者治疗前后应激症状评分、血清氧化应激指标[一氧化氮(nitric oxide,NO)、超氧化物歧化酶(superoxide dismutase,SOD)、总抗氧化能力(total antioxidant capacity,T-AOC)]、免疫功能指标[细胞免疫(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))],体液免疫[免疫球蛋白M(immunoglobulin M,IgM)、IgA、IgG]及肿瘤相关指标[癌胚抗原(carcinoembryonic antigen,CEA)、糖类抗原153(carbohydrate antigen-153,CA153)、糖类抗原125(carbohydrate antigen-125,CA125)]变化情况,观察两组患者临床疗效。结果:治疗后对照组患者相关应激症状积分均升高(P<0.05),治疗组均降低(P<0.05);治疗后对照组患者血清NO水平升高(P<0.05),SOD、T-A0C水平降低(P<0.05);治疗组血清NO水平降低(P<0.05),SOD、T-A0C水平升高(P<0.05)。治疗后对照组患者细胞免疫相关指标CD4^(+)、CD4^(+)/CD8^(+)表达均降低(P<0.05),CD8^(+)表达虽然升高,但差异无统计学意义(P>0.05);治疗组CD4^(+)、CD4^(+)/CD8^(+)表达均升高(P<0.05),CD8+表达虽然降低,但差异无统计学意义(P>0.05)。治疗后两组患者体液免疫相关指标IgM、IgA、IgG表达均升高(P<0.05),治疗组高于对照组(P<0.05)。治疗后对照组患者CEA表达水平升高(P<0.05),但CA153、CA125表达差异无统计学意义(P>0.05);治疗组CEA、CA153、CA125表达水平均降低(P<0.05)。治疗组总有效率为100.00%(30/30),高于对照组的13%(4/30)(P<0.05)。结论:仁术三黄方能改善乳腺癌术后内分泌治疗患者慢性氧化应激状态,提高患者免疫功能,降低癌症复发风险,改善患者气虚血瘀症状,疗效优于单纯内分泌治疗。Objective:To observe clinical effects of Renzhu Sanhuang formula in the treatment of Qi deficiency and blood stasis pattern of postoperative endocrine treatment period for breast cancer.Methods:Sixty patients were randomized into the control group and the treatment group with 30 cases in each group.The control group accepted postoperative endocrine treatment for breast cancer,and the treatment group took Renzhu Sanhuang formula on the foundation of the therapy the control group received.To compare stress symptom score,the indicators of serum oxidative stress including NO,SOD and T-AOC,the indexes of immunological function such as cellular immunity(CD4^(+),CD8^(+)and CD4/CD8^(+)),and humoral immunity(IgM,IgA and IgG),as well as tumorrelated indexes including CEA,CA153 and CA125 before and after the treatment between both groups,to observe clinical effects between both groups.Results:After the treatment,the relevant stress symptom scores increased in the control group(P<0.05),while the socres decreased in the treatment group(P<0.05).After the treatment,the levels of serum NO went up in the control group(P<0.05),the levels of SOD and T-AOC decreased(P<0.05);the levels of serum NO reduced in the treatment group(P<0.05),the levels of SOD and T-AOC elevated(P<0.05).After treating,the expressions of cellular immunity-related indexes such as CD4^(+),and CD4^(+)/CD8^(+)lowered in the control group(P<0.05),though the expressions of CD8^(+)rose,the difference had no statistical meaning(P>0.05);while the increased expressions of CD4^(+),and CD4^(+)/CD8^(+)and the reduced expressions of CD8+were found in the treatment,the difference had no statistical meaning(P>0.05).After the treatment,the expressions of humoral immunity(IgM,IgA and IgG)were elevated in the two groups(P<0.05),the treatment group was higher than the control group(P<0.05).After the treatment,tumor-related index CEA was highly expressed in the control group(P<0.05),the difference had no statistical meaning in the expressions of CA153 and CA125(P>0.05),and the e

关 键 词：乳腺癌 慢性氧化应激 免疫功能 仁术三黄方 

分 类 号：R271.19[医药卫生—中医妇科学]